| NPI | 1548401029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM CCMH0200621) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 6031) |
| 101YM0800X Counselor Mental Health (Licence: TX 14713) | |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2019-01-28 |